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Li Mao Cai
Otolaryngology
About me
With over 10 years of experience in clinical otolaryngology, I have accumulated a certain amount of expertise in diagnosing and treating diseases in this specialty. I have a professional perspective on understanding health issues, believing that prevention is better than cure. Therefore, on online platforms, while addressing the concerns of those seeking advice, I am more willing to provide some popular science knowledge on disease prevention. Those in need are welcome to consult.
Proficient in diseases
Allergic rhinitis, pharyngitis, chronic pharyngitis, sinusitis, nasal polyps, nasopharyngeal carcinoma, laryngeal carcinoma, vocal cord polyps, adenoid hypertrophy, chronic tonsillitis, snoring, tinnitus, thyroid nodules, otitis media, etc.
Voices
Symptoms of recurrent sinusitis
The symptoms of recurrent sinusitis are essentially the same as those of sinusitis itself. Symptoms can be divided into local symptoms, which are those of the nasal cavity, as well as some systemic symptoms, because the recurrence of sinusitis often follows a cold that leads to an acute recurrence. The nasal symptoms mainly include nasal discharge, primarily consisting of yellow pus-like mucus. There may also be nasal congestion or a sensation of the nose being blocked, as well as headaches. The location and severity of the headache depend on which sinus is more severely inflamed, which also affects where the headache is felt. Additionally, there may be a disturbance in the sense of smell, which refers to a reduced sensitivity to smells, or a reduced ability to smell or weak sense of smell. Systemic symptoms mainly include lethargy, feelings of headache and weakness, lack of concentration, and a general lack of energy. Overall, the symptoms of recurrent sinusitis are similar to those of initial sinusitis, with most being the same.
How is suppurative tonsillitis caused?
The acute onset of suppurative tonsillitis is commonly due to a weakened immune system, which then leads to bacterial infection and thus suppurative tonsillitis. For example, getting chilled or getting caught in the rain, or having a persistent cold. Other common causes include irritation from smoking and alcohol environments, spicy foods, and staying up late. Also, if there is some chronic inflammation in the tonsils, these adverse stimuli make it easier to trigger this type of suppurative inflammation. Therefore, in addition to maintaining a normal routine in daily life, it is also important to check for the presence of chronic tonsillitis. If chronic tonsillitis is present, it's crucial to choose a proper opportunity for surgical treatment, which means performing surgery when it is not in an acute phase, to prevent the recurrence of suppurative inflammation.
How to deal with nasal polyps and enlarged turbinates?
Nasal polyps and hypertrophic turbinates require surgical treatment because both are manifestations of chronic inflammation in rhinitis. Medical treatment alone is not very effective in these cases. Nasal polyps and hypertrophic turbinates mainly cause poor nasal ventilation, and over time, can also affect the drainage of the sinuses. Therefore, in patients with significantly enlarged nasal polyps, who often also suffer from chronic sinusitis, treatment involves the endoscopic removal of nasal polyps and partial resection of the inferior turbinate, along with the opening of the sinus passages. This is a systematic and comprehensive treatment approach. After surgery, it is crucial to follow a prescribed medication regimen, as this ensures the effectiveness of the surgery. If surgery is performed without subsequent medication, the results may not be very good. Additionally, regular postoperative check-ups and cleanings are essential to maintain the effectiveness of the surgery and to prevent long-term recurrence. Many patients who cease medication and do not return for follow-up cleanings after surgery are likely to experience a quick recurrence.
Treatment methods for vocal cord nodules
The treatment is primarily divided into conservative treatment and surgical treatment. Generally, conservative treatment is implemented first. The main strategy of conservative treatment is vocal rest, which entails speaking as little as possible, typically for a duration of two to four weeks. Concurrently, medication is administered, often through nebulized inhalation therapy. The second approach is surgical treatment, which is considered if the conservative treatment does not yield satisfactory results, or if the condition worsens. At this point, surgical treatment of vocal cord nodules is typically performed using support laryngoscopy, microscopy, and either laser or fiber instruments to remove the vocal cord nodules. Post-surgery, a period of vocal rest is necessary for recovery, also lasting two to four weeks. During the recovery period, it is important to speak less, use proper phonation, avoid smoking and alcohol, follow a light diet, and steer clear of spicy and irritating foods.
The difference between vocal cord polyps and laryngeal cancer
The difference between vocal cord polyps and laryngeal cancer is firstly notable in their nature. Vocal cord polyps are benign lesions, and their removal generally does not significantly affect the patient's quality of life or lifespan. Laryngeal cancer, as the name implies, is a malignant lesion that greatly affects both the patient's quality of life and lifespan. Location-wise, vocal cord polyps are found on the vocal cords, while laryngeal cancer can be located in one of three areas: on the vocal cords, known as glottic laryngeal cancer; below the vocal cords, known as subglottic laryngeal cancer; and above the vocal cords, known as supraglottic laryngeal cancer. The prognosis for vocal cord polyps is very good; after surgery, if the patient rests well, their future quality of life is generally unaffected. Laryngeal cancer is divided into three types: glottic, supraglottic, and subglottic, with glottic being the most common, accounting for about 80%. This type of laryngeal cancer usually presents early symptoms such as hoarseness, similar to vocal cord polyps. Therefore, glottic laryngeal cancer can often be detected early. With prompt and correct treatment, the postoperative results can be good. As it typically involves highly differentiated squamous cell carcinoma, if it is completely excised surgically and regularly reviewed postoperatively, it doesn't greatly impact lifespan or quality of life. In contrast, subglottic and supraglottic laryngeal cancers often show symptoms later, which means they tend to be diagnosed at a later stage, usually at a mid to advanced stage. Supraglottic laryngeal cancer, in particular, is prone to cervical lymph node metastasis, thus usually having a poorer prognosis compared to glottic laryngeal cancer. There's also a higher likelihood of recurrence and metastasis, and the surgery may involve greater trauma. These are the main differences.
How is chronic tonsillitis diagnosed?
The diagnosis of chronic tonsillitis mainly relies on the patient's usual symptoms, medical history, and physical examination by the doctor. The symptoms of chronic tonsillitis typically include sore throat, frequent colds, dry throat, itchy cough, foreign body sensation, and even snoring during sleep among some individuals. Medical history is particularly crucial. If there are recurrent acute episodes, characterized by sore throat, painful swallowing, and sometimes accompanied by high fever, and these episodes occur more than four times a year, this history is significant for diagnosing chronic tonsillitis. Additionally, physical examination by a doctor, who will inspect the tonsils, is essential for making the diagnosis of chronic tonsillitis. The main basis for diagnosis includes symptoms, medical history, and physical examination.
What are the symptoms of chronic tonsillitis?
The symptoms of chronic tonsillitis during the non-acute phase vary from person to person. Some individuals may not exhibit clear symptoms, while others may display more typical ones. The most common symptoms include recurrent sore throat, and sensations of dryness, itchiness, the presence of a foreign body, and discomfort in swallowing or coughing. Another common symptom is persistent cough, which can be irritating, with some individuals frequently clearing their throat. Bad breath may also occur, such as when stone-like substances form on the tonsils and are expelled, carrying a foul odor. If the tonsils are excessively enlarged, they can interfere with breathing, cause snoring during sleep, and even lead to breath-holding, resulting in unclear speech, as if speaking with a mouthful. These are commonly seen in clinical settings. Additionally, some systemic reactions may occur, including fever, fatigue, low-grade fever, and headaches.
What are the symptoms of pharyngitis?
There are many symptoms of pharyngitis, and the specific symptoms can vary from person to person. The most common ones include the following. The first is a foreign body sensation, which is a sensation of a foreign object in the throat, feeling like there is always something that cannot be coughed up or swallowed, which is very typical. Another one is the empty swallow syndrome, meaning that some people feel like there is something that cannot be swallowed when swallowing saliva without food. Empty swallowing refers to just swallowing saliva in this way, feeling more and more like there’s something stuck as one swallows, which is similar to the foreign body sensation and is also a manifestation of the swallowing action. The third symptom is a dry and itchy throat. Some people also experience symptoms such as feeling nauseous and wanting to gag when brushing their teeth in the morning. Therefore, the symptoms of pharyngitis do not manifest exactly the same in everyone; some people may experience several symptoms, while others may have one predominant symptom.
The difference between vocal cord polyps and vocal cord nodules
Vocal cord polyps and vocal cord nodules are diseases caused by incorrect pronunciation or overuse of the voice, with the main clinical manifestation being hoarseness. The difference between vocal cord polyps and vocal cord nodules lies in their appearance under a laryngoscope: Vocal cord polyps often occur on one vocal cord, typically in the anterior one-third where a translucent, smooth swelling is found. This swelling can either have a broad stalk or a smaller stalk, and often, a hole can be observed with respiration. Vocal cord nodules are smaller and usually located symmetrically on the anterior one-third of both vocal cords. This implies that while polyps are commonly found on one vocal cord, nodules occur symmetrically on the anterior one-third of both vocal cords. From a general perspective, vocal cord polyps are wider and larger, whereas vocal cord nodules are only nodular lesions.
What are the dangers of a deviated septum?
The main harms of a deviated nasal septum include several points, mainly causing uncomfortable symptoms. Firstly, the most common symptom is nasal congestion, which is often unilateral, meaning one side of the nose is blocked depending on the side the septum is deviated towards while the other side remains relatively normal. Severe deviation to one side can cause blocked sensation in the nose, or it can affect both sides leading to bilateral congestion. The type of deviation, such as a simple deviation or an S-shaped one where both the front and back are deviated in different directions, can result in blockage in both nasal passages. Another issue is nosebleeds. Sometimes, the deviated septum can form a sharp edge, making the nasal mucosa fragile or piercing other areas, which can easily cause bleeding. Additionally, it can cause headaches due to the pressure exerted on the concha of the opposite side by the deviated septum. It also leads to conditions like rhinitis and sinusitis because the deviation affects the drainage of the nasal cavities and sinuses, resulting in secondary sinusitis, which causes long-term headaches, discomfort, and a series of sinusitis symptoms.